Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00132352 Renewal 01/22/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(14)Individual #1's physical examination dated 2/21/17 did not document information pertinent to diagnosis in case of an emergency.The physical examination shall include: Medical information pertinent to diagnosis and treatment in case of an emergency. This citation was reviewed with all program specialists on 2/1/18. This specific citation was due to physical form that came with a recent admission (DB) from another provider under different regulations. A correction was made for this violation with a new physical completed for DB on 2/21/18 (Attachment #2). The physical form in use by our agency includes the information needed for regulatory compliance. However the admissions committee has reviewed the regulation to ensure this information is included on all physical forms for new admissions. The program specialists will be responsible for ensuring that all physicals are in compliance for new admissions moving forward. Lastly, all physicals for new admissions within the last year will be reviewed by responsible program specialists to ensure compliance by 6/30/18. 06/30/2018 Implemented